Diverticulitis/CRC Flashcards
site of most diverticulosis
sigmoid colon
tx diverticulosis
high fiber diet (25-40 g/day)
adequate fluids
complication of macroperf in diverticulitis
free air, peritonitis
complications of diverticulitis (4)
abscess- walled off perforation
fistula- to the bladder or vagina
obstruction- due to inflammation
perforation
progressive, steady/aching LLQ pain, fever, tachycardia (from pain)
N/V, constipation, diarrhea, urinary sx
complicated diverticulitis
rigid abd with guarding, rebound tenderness, & absent bowel sounds
peritonitis
lab findings for diverticulitis? (3)
CBC- leukocytosis w/ left shift
stool for fecal occult
DRE for rectal mass
test of choice for diverticulitis dx?
CT scan
CT findings for diverticulitis (4)
fat stranding
bowel wall thickening
diverticulosis
the 4 complications (abscess, fistula, obst., perf)
flex sig/colonoscopy/BE use in diverticulitis?
contraindicated in acute diverticulitis due to perf. risk
tx uncomplicated diverticulitis (4)
metronidazole 500 mg PO TID
Cipro 500 mg PO BID 10-14 days both
clear liquid diet 2-3 days
colonoscopy 4-6 wks after episode
indications for hospitalization with diverticulitis (4)
toxic appearance
inability for PO
comorbidities (elderly, immunocomp.)
complication
inpt tx diverticulitis (4)
NPO (1-2 days)
IV fluids
Demerol
IV abx w/ G- and anaerobic coverage
indications for inpt emergent surgery for diverticulitis
peritonitis
failure to improve w/in 3-4 days
most common cause of acute lower GI bleed in the U.S.
diverticular bleeding
sx of diverticular bleeding (3)
painless bleeding
occult blood
hematochezia
pathology & common site of diverticular bleeding
artery is draped over length of diverticulum which is easily exposed to injury
usually Right side
diagnostics for diverticular bleeding (2)
1st: EGD/NG to r/o UGI source
2nd: Flex Sig or Colonoscopy
locate the source of the bleeding